Tonographic survey of the close relatives of patients with chronic simple glaucoma.

Abstract

THAT glaucoma simplex may affect more than one member of a family is well known, but this would usually appear to occur in a sporadic fashion and have no hereditary significance. When true hereditary glaucoma occurs it is found in many members of the same family and is frequently traced over three or four generations. These families are, however, rare and have been well documented (Francois, 1961). Recently studies have been carried out on relatives of patients with glaucoma simplex in an effort to assess the hereditary element in the pathogenesis of the disease. The first reports by Biro (1951) and Kellerman and Posner (1955) were followed by tonographic surveys of the close relatives of glaucoma simplex patients, in particular by Becker, Kolker, and Roth (1960), Paterson (1961), and Miller (1961). MaterialIn this investigation 62 patients with chronic simple glaucoma were selected from the records of Whipps Cross Hospital. The following criteria were used for selection:(a) Field defect and cupped disc in one or both eyes unexplained except by the diagnosis of glaucoma. (b) Open angles as seen by gonioscopy.No account was taken of the initial or subsequent intra-ocular pressure in this selection. Method A family tree of the children and siblings of each patient was made and all subjects who lived within a reasonable distance of the hospital were then asked to attend for a single eye examination. From the 62 families selected, children or siblings or both were seen from 42 families, and the examination included the following:(1) Corrected visual acuity.(2) Estimation of depth of anterior chamber (i.e. shallow, medium, or deep) together with a general slit-lamp examination. (3) Assessment of optic discs. (4) Applanation tonometry of both eyes with a Goldmann applanation tonometer. (5) Tonography of both eyes with a Schwarzer electronic recording tonometer. Coefficient of outflow facility (c) was estimated using tonographic tables for eyes with average scleral rigidity. The ratio PO/c (PO = intra-ocular pressure and c = coefficient of outflow facility) was calculated. This measurement was introduced by Leydhecker (1958a) to distinguish between normal and early glaucomatous eyes and a value above 100 is now generally accepted as being abnormal.

Involvement of RhoA/Rho-Associated Kinase Signal Transduction Pathway in Dexamethasone-Induced Alterations in Aqueous Outflow

“…[1][2][3][4][5] Many risk factors, such as age, 4,5,28 steroid administration technique, 4 and diagnosis of open-angle glaucoma, 1,2,[29][30][31] are associated with the IOP elevation in response to steroid administration. These findings imply that changes in cellular behaviors caused by steroids may differ between patients.…”

Glucocorticoid therapy and ocular hypertension

“…In contrast, nearly all of POAG patients are steroid responders (Paterson 1965; Davies 1968; Schwartz et al, 1973; Meredig and Pulhorn 1980; and Bartlett et al, 1993). …”

Corticosteroid-induced glaucoma: a review of the literature

“…It has been reported that there is a greater risk of corticosteroid response in patients with certain types of connective tissue disease, 9 type I diabetes, 10 a first-degree relative with primary open-angle glaucoma (POAG), [11][12][13] or high myopia. 14,15 Other steroid-induced ocular effects that have been reported include an increase in corneal thickness and a slight mydriasis, but these changes have not been shown to correlate with an ocular hypertensive response.…”